The Uniform Medical Plan (UMP) was built to provide top-quality, affordable healthcare to eligible Washington state public employees (active and retired), Leave Without Pay members, non-Medicare retirees or COBRA members. Uniform Medical Plan CDHP 2017 Certificate of Coverage (COC) www.hca.wa.gov. (Medical services). These are complex claims, Hensley said. Where should I submit claims? An authorization must be on file to ensure proper claims payment. Regence Uniform Medical Plan (UMP) Insurance Connections Behavior Planning & Intervention is a preferred provider with Regence UMP. A claim denied as a duplicate when services were performed more than one time, and payment does not reflect multiple service payment. Member claims. View our guidelines for claims submission and helpful coding resources. 4. an informed decision. Even though I am "out-of-network" with all Regence, Health Management Administrators (HMA), and Uniform Medical Plans, I am happy to submit claims on your behalf for your out-of-network benefits. Use the electronic authorization tool to determine whether pre-authorization is required and submit requests online. Sound Generations helps individuals understand the basics of Medicare, long-term care and related insurance, plan for retirement, process medical billings, claims and appeals and understand health care reform. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Contact lenses are medical devices and require an exam to obtain or renew your prescription. Sign the completed form where indicated at the bottom of this page and submit the completed claim form to: Regence BlueShield Attn: UMP Claims PO Box 1106 Lewiston, ID 83501-1106 or by fax to: 1 (877) 357-3418 Payments will be mailed to the address on file for the subscriber. Our Provider Contact Center is available for information that cannot be served by the Availity Portal. Primary member/subscriber ID number* Group/employer name: Uniform Medical Plan . Box 7968 Madison, WI 53707-7968 www.tricare-overseas.com: Eurasia Africa (All Others) TRICARE Overseas Program P.O. To browse each plan’s network or to find a … Pre-authorization: Use our online tool to be routed to the home plan's requirements. Group - Fully-insured and administrative services only (ASO) Individual; Medicare Advantage plans; Uniform Medical Plan: 1 (888) 849-3682 . Regence BlueShield assumed administration functions for the state’s Uniform Medical Plan (UMP) in January 2011. Box 52890 Bellevue WA 98015 or fax at 1 … Overseas (Active Duty) TRICARE Active Duty Claims P.O. If you do not submit your claims through the Availity Provider Portal, follow this process to submit your claims to us electronically. This includes all applicable professional and facility claims: • Effective April 1, 2019, for professional services • Effective May 1, 2019, for facility services These requirements apply to all Regence plans (group, Individual, Uniform Medical Plan [UMP], We accept electronic claims through Availity using payer ID RGA01. You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Group - Fully-insured and administrative services only (ASO). You will be prompted to enter your tax identification number (TIN). Tacoma, WA 98401-2998. Learn about submitting BlueCard claims. Your evidence must support that you followed Regence policy. The time limit for filing claims is one year from the date of service/purchase. Are you covered by Regence and another health insurance company? Your account at www.regence.com. You can verify your address by calling PEBB UMP Customer We provide Applied Behavioral Analysis (ABA) therapy benefit for Regence UMP members.Regence will cover ABA Therapy. Preauthorization. UMP Achieve 1 UMP Achieve 2 UMP High Deductible UMP Plus—Puget Sound High Value Network UMP Plus—UW Medicine Accountable Care Network UMP Plus— Puget Sound Uniform Medical Plan ublic Employees Benefits Board (PEBB) – 10008217 . The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Sign up for EFT and quickly receive payment. Prescription Drug Claim Form . Preventive care list Check this list to see which preventive services are covered, for whom and how often they are recommended. Thank you for choosing Regence for your health care coverage. For services abroad please utilize the International Claim Form located at www.bcbsglobalcore.com. About Uniform Medical Plan (UMP), administered by Regence BlueShield. 4. Fill in this form (sign-in required) to give us information about your other coverage. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. Blue Shield of Idaho PO Box 30270 Salt Lake City, UT 84131-0207. To help you decide on a plan, it can be helpful to know the network—or the group of doctors, hospitals and pharmacies that are part of the plan. Access Regence Group Administrators member forms for appeal submissions, care claims, and authorizations. No enrollment needed, submitters will receive this transaction automatically, Web portal only: Referral request, referral inquiry and pre-authorization request, Implementation Acknowledgement for Health Care Insurance. Regence 1800 Ninth Avenue PO BOX 91015 Seattle, WA 98111-9115 h ttE c' Uniform Medical Plan MEDICAL CLAIM FORM Use this form to submit reimbursement requests for services received from a non-network provider. We provide flexible, affordable health care for members of the School Employees Benefits Board (SEBB) and Public Employees Benefits Board (PEBB) programs.. PSHVN has a large geographic footprint with over 6,500 providers and 1,100 locations. Find hearing information and important documents from the Washington state Office of the Insurance Commissioner regarding Regence BlueShield. Learn more about informational, preventive services and functional modifiers. Depending on your insurance plan, your out-of-network cost may be … Download and print helpful material for your office. As a member, you can register and sign in to view your claims and benefits information and get access to members-only tools. Uniform Medical Plan (UMP) is a self-insured health plan offered through the Washington State Health Care Authority’s (HCA) Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program.UMP is administered by Regence … Claims and correspondence. We can work with that company to reduce your costs. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. You can verify your address by calling PEBB Customer Service at Provider claims. What are my plan options? Please complete a separate form for each family member. Provider Contact Center: 1 (800) 253-0838. Our interactive voice response system is also available 24 hours a day, seven days a week when calling the Provider Contact Center. For information that cannot be served by the Availity Portal, our Provider Contact Center is available Monday through Friday, 6 a.m. to 5 p.m. (PT). Blue Shield of Idaho PO Box 30270 Salt Lake City, UT 84131-0207. Host Plan phone: Monday through Friday, 6 a.m. to 5 p.m. (PT). Regence Blue Shield in accordance with the terms of your provider contract with Regence. You are about to leave regence.com and enter another website that is not affiliated with or … Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. Video en español About Uniform Medical Plan Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s Public Employees Benefits Board (PEBB) Program. A contact lens exam is not included in the annual eye exam and eye health exam. Regence BlueShield Regence BlueShield serves select counties in the state of 1800 Ninth Avenue | Seattle, WA 98101 Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association © 2020 Regence BlueShield What’s new at UMP (PEBB) for 2021 This section applies to requests for appeal when: NCCI or CCE coding rules apply to a claim or claim line. Coordination of Benefits, Medicare crossover and other party liability or subrogation. Frequently Asked Questions. Claims mailing address. The mission of Sound Generations is to assist and educate people of all ages so they can make informed insurance decisions. UMP is administered by Regence BlueShield and Washington State Rx Services. For prescription, supplies or medical equipment requests, please complete a "Prescription & Durable Medical Equipment Claim Form" (PD001). To submit a claim online, go to the “Member Dashboard / Claims” section and select the yellow “Submit a Claim” button. admission. Provider Contact Center staff will also verify that the TIN you entered corresponds to the member you are calling about. Claims Department P.O. Use this claim form for any reimbursement requests you may have or if you prefer, send a copy of your bill with your Group and ID Numbers written at the top and mail to the address below. This exam includes computerized topography and mapping of the cornea as well as an evaluation of which lenses will fit and provide optimal comfort, vision, and eye health. In August, the Health Care Authority (HCA, which administers the PEBB Program) called for a recovery plan after Regence had amassed more than 300,000 backlogged claims-most of them Medicare claims by retired state workers. National BlueCard member benefits and eligibility: Phone 1 (800) 676-2583, Monday through Friday, 7:30 a.m. to 10 p.m. (PT). Provider Contact Center: 1 (800) 253-0838. Fax 1-844-679-7763. Providers call 1-888-849-3682. The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. You can also submit claims via mail to our claims address P.O. PO Box 2998. (medical services). Phone: 800-732-1209. Learn more about the plans. PART 1: *Indicates required information. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. Sign the completed form where indicated at the bottom of this page and submit the completed claim form to: Regence BlueShield Attn: UMP Claims PO Box 1106 Lewiston, ID 83501-1106 Or by fax to: 1-877-357-3418 Payments will be mailed to the address on file for the subscriber. Online access to medical claims. Note: Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan … The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. For information that cannot be served by the Availity Portal, our Provider Contact Center is available Monday through Friday, 6 a.m. to 5 p.m. (PT). The remainder goes to Regence, which on behalf of the state pays the rest, or however much the state Uniform Medical Plan allows. Box 202112 Florence, SC 29502-2112 www.tricare-west.com. Learn more about when, and how, to submit claim attachments. Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s School … Learn more about our customized editing rules, including clinical edits, bundling edits, and outpatient code editor. Fax 1-877-663-7526. What is a Uniform Medical Plan (UMP)? Find forms to request pre-authorization, care management or appeals, or direct overpayment recovery. With the Uniform Medical Plan, you may choose from the plans listed below. In Payer Spaces you can access our reimbursement schedules, pricing documents and more. Fax: 800‐207‐8235, ATTN: Rx Claims Department . Access most member eligibility, benefits and claims information online using the Availity Portal. Claims, and outpatient code editor via mail to our claims address P.O 53707-7968. All ages so they can make informed insurance decisions 2017 Certificate of coverage ( COC www.hca.wa.gov... 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